| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
9,448 |
7,019 |
$108K |
| A4267 |
Contraceptive supply, condom, male, each |
7,584 |
4,440 |
$104K |
| J3490 |
Unclassified drugs |
11,996 |
7,142 |
$87K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
8,562 |
8,528 |
$63K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,112 |
3,455 |
$47K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,642 |
1,040 |
$29K |
| 81025 |
|
5,124 |
4,000 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,107 |
976 |
$21K |
| S4993 |
Contraceptive pills for birth control |
2,112 |
1,291 |
$14K |
| 99201 |
|
1,357 |
1,037 |
$13K |
| J7307 |
Etonogestrel (contraceptive) implant system, including implant and supplies |
230 |
170 |
$10K |
| S0199 |
Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs |
656 |
318 |
$10K |
| 99000 |
|
3,476 |
2,869 |
$7K |
| Q0111 |
Wet mounts, including preparations of vaginal, cervical or skin specimens |
1,896 |
1,647 |
$4K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
8,541 |
8,505 |
$3K |
| 87806 |
|
4,103 |
3,460 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,036 |
658 |
$2K |
| 11982 |
|
244 |
104 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
233 |
190 |
$1K |
| 83986 |
|
1,774 |
1,571 |
$1K |
| S0190 |
Mifepristone, oral, 200 mg |
470 |
258 |
$1K |
| 11981 |
|
267 |
163 |
$1K |
| 11976 |
|
27 |
14 |
$702.82 |
| 85018 |
|
949 |
580 |
$548.44 |
| Q0144 |
Azithromycin dihydrate, oral, capsules/powder, 1 gram |
1,096 |
713 |
$163.68 |
| 86901 |
|
291 |
168 |
$0.00 |
| 58301 |
|
68 |
28 |
$0.00 |
| 58300 |
|
102 |
37 |
$0.00 |
| 59840 |
|
88 |
26 |
$0.00 |
| J7304 |
Contraceptive supply, hormone containing patch, each |
14 |
12 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
24 |
24 |
$0.00 |
| S0191 |
Misoprostol, oral, 200 mcg |
480 |
254 |
$0.00 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
237 |
234 |
$0.00 |
| 81002 |
|
92 |
79 |
$0.00 |